主动脉病变腔内修复术中导入动脉的外科处理

目的 探讨主动脉病变腔内修复术中对于导入动脉的外科处理方式。方法 回顾性分析南方医科大学南方医院血管外科2001年1月至2007年12月63例主动脉腔内修复术病人的临床资料，其中主动脉夹层33例，腹主动脉瘤25例，主动脉假性动脉瘤5例。结果 导入动脉分别选用股总动脉57例，髂外动脉6例。动脉切口单纯修补38例，动脉成形后修补16例，内膜剥除加单纯修补4例，动脉部分切除后行端端吻合4例，人工血管置换1例。62例病人获得成功，1例术中死亡。所有成功施行腔内隔绝术的病人中，1例术后出现导入动脉假性动脉瘤，通过再次手术治愈；2例术后出现患侧下肢轻微缺血症状，经造影证实为吻合口狭窄，予以保守治疗治愈，其他病人未出现并发症。 结论 术前详尽的评估，术中仔细的保护，术后根据情况及时进行相应处理，可有效防治导入动脉相关的并发症。

Surgical management for access artery in the endovascular exclusion repair of aorta

Surgical management for access artery in the endovascular exclusion repair of aorta LIN Zhi-qi, WAN Heng , LIU Zheng-jun, et al. Department of Vascular Surgery and Ultrasonography, Nanfang Hospital , Southern Medical University, Guangzhou 510515, China Corresponding author: WAN Heng, E-mail: wanheng1212@yahoo.com.cn Abstract Objective To summarize the surgical management in the endovascular exclusion repair of aorta. Methods Recheck the clinical data of the 63 patients who underwent treatment of endovascular exclusion repair of aorta from January 2001 to December 2007. Result 57 in the all 63 patients choosed femoral artery as the access artery, and external iliac artery was choosed in the rest 6 cases. 38 cases administrated simple repair, 16 cases repaired with located shaping, 4 cases repaired with endarterectomy, 4 cases applied end-to-end anastomosis with excision part of the artery.1 case accepted prostheses replacement. 62 cases were succeed, 1 case died in the EVER procedure. In the all 62 cases, 1 case occurred pseudoaneurysm in the anastomosis, which cured by reoperation.2 cases occurred mild ischemia in the lower limb, which dignosed stenosis of anastomosis by DSA. The symptoms of ischemia was cured by medicine without operation. Conclusion Detailed evaluation before the operation, careful protection in the procedure, and appropriate management after operation are effective for prevention and cure the complications relative to access artery.